Do you find the nursing theorists/theories you studied in school useful in real life?

nursee* · Jun 17, 2012

These comments are enlightening. Nursing theories do not work in the trenches but they do make you think. Thinking is good. I remember getting very impatient with the lofty theories I was taught only to find that they are a bunch of work and not much help on a hospital ward. In fact, they caused more paper work. The care plans and nursing diagnoses were there because they had to be but no one had time to look at them. What they did do is make you think and create a more organized process for patient care. You knew the "whys" of what you were doing.

MunoRN, RN · Jun 17, 2012

Orem -- Self care deficit, need for patient to progress in toileting practices to be able to go home
Henderson -- Same idea
Benner -- beginner nurse just "followed the routine" while more advanced nurse intervened to think of things to do to help the patient progress
Newman's System Model -- understanding that bedpan use would complicate home care
Any of the caring theorists -- actually helping the patient move forward (rather than just maintaining a routine that keeps the patient totally dependent) is an act of caring and compassion
Abdullah -- assistance with elimination -- working to maintain normal/previous patterns of elimination
etc. etc. etc. I could go on and on.

This is a good example of why many Nursing Theories are criticized; they are too often nothing more than long-winded explanations of the obvious. The idea that a person might prefer to go to the bathroom in a manner they are used to and provides a sense of independence and higher functioning by using a commode rather than on one of the least comfortable contraptions imaginable did not require a theory. There are plenty of people for whom these basic premises of human nature are obvious even though they have never heard of any of these theories.

As others have mentioned, not all theories are embarrassments to the basic principles of science. Benner's for instance helps define and measure the stages of Nursing professional growth. Others use a combination of plagiarized psychological theories and statements of the obvious that really don't advance our understanding in any measurable way.

If someone feels a Nursing theory provides them with some sort of epiphany that's great and I'm all for it, although I've also had people tell me watching the Wizard of Oz while listening to Pink Floyd gave them a deeper understanding of life, although I'm not convinced it really expanded their understanding so much as they experienced a sort of placebo induced epiphany; they convinced themselves it was going to enlighten them, even though there is no reason to believe it was capable of doing anything more than what they could have understood without it. (Drugs may have also been involved).

llg, PhD, RN · Jun 17, 2012

Whatever did we do before the 1970s when this stuff was first introduced?

You're showing your lack of knowledge about theory Sue -- or maybe your lack of clear thinking on the topic. There was theory before the 1970's. Let's not forget Nightingale ... and the many others who came before us.

SuesquatchRN, BSN, RN · Jun 17, 2012

Well, my first post, on the first page, referenced Flo. You, as a guide, shouldn't be engaging in sideways personal attacks. Or maybe you're just showing your rear.

MunoRN, RN · Jun 18, 2012

You're showing your lack of knowledge about theory Sue -- or maybe your lack of clear thinking on the topic. There was theory before the 1970's. Let's not forget Nightingale ... and the many others who came before us.

Nightingale never wrote any theories, although her work on cleanliness and health came close. It's not as though she wasn't aware of theoretical frameworks and their purpose, she was very scientifically minded (she invented the polar area diagram). She did not force her observational statements into theoretical frameworks where they didn't belong, that was done later.

PennyWise · Jun 18, 2012

I used to think it was stupid. But I now think (and this is not based on pursuing a post-grad degree in nursing, just on looking at the world of nursing) that a lot of what we think of as "common sense" in nursing is actually based on some of that theory. We just don't realize we're using something that got knocked into the back of our heads. I think learning the theory (and how to careplan,) teaches us to think through situations. And that's the biggest thing that I think a nurse does, and the difference between an ok nurse and a great nurse. An ok nurse will get all the work done, not make any mistakes. But to do the job really well, we think through what needs to be done and what needs to happen to get the patient to the optimal outcome. (Although I admit, the nursing diagnosis thing is ridiculous, we could learn it just as well by saying "asthma" rather than "impaired gas exchange.")

Funny, I've always been on the other side of the coin with this. For me, its always been an issue of the theorists not realizing most of their work is derived from common sense, not the other way around. Hence, nursing theory is not greatly respected by other professions and not even by its own members.

My interpretation of Watson's theories and how it can be implemented is a very loose interpretation indeed. I have to make a few assumptions to take it from being fodder to being useful.

I think part of what is holding nursing back is the fact that too many of our leaders cling to old/outdated concepts that do nothing to promote our profession. I most definitely consider nursing diagnosis and care planning a part of this phenomenon. It seems as if many of those in academia defend nursing theory (and nursing diagnosis and care planning) out of fear. They live in fear of the nursing profession being accussed of having no "unique body of knowledge" so they defend inadequate theories just to feel as though "something is there". They also fear not being able to do better and hence take refuge in w/e is in place instead of trying to improve on our body of knowledge.

Every profession/trade/science goes through its growing spurts. Old ideas are thrown away and new/better ones take their place. Nursing on the other hand tends to spin it's wheels a lot. Part of the reason for this is what I talked about above.

Could you imagine if everyone acted as we often do, clinging to poorly thought out concepts just for the sake of feeling as though we have something worth defending? Explorers would still be insisting the world is flat, doctors would still be drilling holes in the heads of their patients to cure headaches and morris code would still be considered the height of communication.

That is the spot nursing finds itself in. Time to tweek our theory, but everyone is too afraid to. We're to busy defending what is already there instead of working towards improving our "unique body of knowledge".

While those who too freely bash nursing and try to say "nurses just need to change bed pans with a smile" hurt our profession, so to do those who are too quick to defend nursing theory insisting we hold onto old ideas that are long overdue for improvement/replacement.

That Guy, BSN, RN, EMT-B · Jun 18, 2012

Funny, I've always been on the other side of the coin with this. For me, its always been an issue of the theorists not realizing most of their work is derived from common sense, not the other way around. Hence, nursing theory is not greatly respected by other professions and not even by its own members.
My interpretation of Watson's theories and how it can be implemented is a very loose interpretation indeed. I have to make a few assumptions to take it from being fodder to being useful.
I think part of what is holding nursing back is the fact that too many of our leaders cling to old/outdated concepts that do nothing to promote our profession. I most definitely consider nursing diagnosis and care planning a part of this phenomenon. It seems as if many of those in academia defend nursing theory (and nursing diagnosis and care planning) out of fear. They live in fear of the nursing profession being accussed of having no "unique body of knowledge" so they defend inadequate theories just to feel as though "something is there". They also fear not being able to do better and hence take refuge in w/e is in place instead of trying to improve on our body of knowledge.
Every profession/trade/science goes through its growing spurts. Old ideas are thrown away and new/better ones take their place. Nursing on the other hand tends to spin it's wheels a lot. Part of the reason for this is what I talked about above.
Could you imagine if everyone acted as we often do, clinging to poorly thought out concepts just for the sake of feeling as though we have something worth defending? Explorers would still be insisting the world is flat, doctors would still be drilling holes in the heads of their patients to cure headaches and morris code would still be considered the height of communication.
That is the spot nursing finds itself in. Time to tweek our theory, but everyone is too afraid to. We're to busy defending what is already there instead of working towards improving our "unique body of knowledge".
While those who too freely bash nursing and try to say "nurses just need to change bed pans with a smile" hurt our profession, so to do those who are too quick to defend nursing theory insisting we hold onto old ideas that are long overdue for improvement/replacement.

Perfection. I quoted it simply because it needs to be seen again by people.

Music in My Heart · Jun 18, 2012

I'm studying Porifice's theory of humanbecoming. I find it hard to implement in the clinical setting. Did the theories that you studied in college come in handy in the clinical setting?

Put me in the "NO" camp.

I'm an applied scientist and that's the approach that I take to my job. I'm also a "golden rule" believer and a staunch proponent of the "do your best" and "be prepared" parts of the Boy Scout motto and pledge.

Nothing in nursing theory comes close to usurping any of those nor adding to them... silly stuff, IMO, which primarily derives from the need to write dissertations to earn PhDs.

llg, PhD, RN · Jun 18, 2012

Funny, I've always been on the other side of the coin with this. For me, its always been an issue of the theorists not realizing most of their work is derived from common sense, not the other way around. Hence, nursing theory is not greatly respected by other professions and not even by its own members.
Great post. I agree with the core ideas. A lot of nursing theory is simply the theorists attempts to organize the knowledge and thought processes that are already generally known and/or common sense. BUT THAT'S OK. That's one of the major functions of a theory.
Too many people mistakenly believe that a theory is supposed to give you new knowledge, new facts. But that's not really the case. A theory organizes information and suggests relationships among key concepts. A practitioner, teacher, or researcher can use that framework to organize their thoughts in practice, present knowledge to a learner, or develop a research project. But it is not the purpose of many theories to give facts/knowledge.
Yes, we need to continually tweak our old theories and develop new ones. And yes, too many people cling to the old theories as if they were handed down by God, intended for all times. But too many people take that truth and interpret as meaning that we should throw all of the old theories away completely and/or stop theorizing completely. As the old saying goes, they want to "throw the baby out with the bath water."
We need to think in terms of tweaking ... and evolving ... and continued development ... etc. and not just think in terms of the extreme options of either "drinking the cool-aide" or "It's all garbage and a waste of time." The middle ground needs to be found.
"Theory bashing" threads start up a couple of times each year. It gets tedious. But I am grateful for PennyWise for adding an intelligent, reasonable post to the old debate. Thank you.

llg, PhD, RN · Jun 18, 2012

Nightingale never wrote any theories, although her work on cleanliness and health came close. It's not as though she wasn't aware of theoretical frameworks and their purpose, she was very scientifically minded (she invented the polar area diagram). She did not force her observational statements into theoretical frameworks where they didn't belong, that was done later.

That doesn't mean she wasn't a theorist.

Been there,done that, ASN, RN · Jun 18, 2012

***snort***

Shucks... now there's coffee all over my screen.

There are so many things that nurses need to study, other than some THEORY .

It is unfortunate that the true study of nursing, is wasted on issues we will never use.

MunoRN, RN · Jun 18, 2012

That doesn't mean she wasn't a theorist.

Actually that's exactly what it means. This would be true if you were stating that she utilizes theories in general (which is true of every living human), although that's clearly not the definition you were using.